Gov. Wolf Pleads To Ryan: Affordable Care Act Needed For Substance Abuse Treatment
Last week, Gov. Tom Wolf senf a letter to house Speaker Paul Ryan (R-Wis), asking that he visit a drug treatment center in Pennsylvania. In the letter dated January 25, he stated that if President Trump repeals and does not replace the Affordable Care Act (ACA), tens of thousands of Pennsylvania residents would lose coverage for substance abuse treatment:
“We can all agree that the Affordable Care Act, or Obamacare, is not perfect. However, the ACA allowed me to expand Medicaid here in Pennsylvania which gave 700,000 more people insurance coverage. Through Medicaid expansion, 63,000 Pennsylvanians suffering from addiction accessed drug and alcohol treatment.
If the Affordable Care Act, or Obamacare, is repealed and not replaced, over a million Pennsylvanians could lose access to health care and tens of thousands of people that are currently receiving treatment for a substance use disorder would lose insurance coverage and no longer be able to afford their treatment.”
According to the Centers for Disease Control and Prevention, in 2015, there were over 3,500 overdose deaths in Pennsylvania – a marked increase of 20% over 2014.
Gov. Wolf posits that the number of overdoses will be even higher for 2016. The two most common drugs related to fatalities are heroin and fentanyl, in that order.
Last September, the governor called a Joint Session of the General Assembly to address the epidemic. He then signed five new bills into law last November.
The new legislation aims to:
- Tighten restrictions on physician prescribing to minors.
- Establish a curriculum in academic and training facilities that provides medical training related to opioids.
- Require continuing education in pain management, addiction, and drug dispensing.
- Restrict the duration/dosage of opioids prescribed by emergency departments and urgent care clinics.
- Create additional drop-off locations for unwanted and/or expired prescription drugs.
In a statement. Gov. Wolf said that the new legislation reflects a commitment to help those suffering from substance use disorder, as well as the communities that have been affected by the opioid overdose epidemic.
Physician General Dr. Rachel Levine reports that the state is now taking an approach that includes multiple state agencies, including the Department of Corrections, the Department of Drug and Alcohol Programs, the Department of Human Services, the Department of State, and law enforcement.
“This is a major priority for Gov. Wolf and the administration.”
Levine has approved two standing order prescriptions for naloxone since 2015. The first was for emergency responders, and last October, she signed an order allowing the public to obtain naloxone at pharmacies.
Naloxone, or Narcan, is an anti-overdose drug that effectively reverses life-threatening effects of central nervous system depression caused by opioids. The drug has saved thousands of lives in Pennsylvania alone.
Levine states that naloxone is “necessary but not sufficient” and added that the state has also established a substance abuse treatment referral program for patients admitted into emergency departments.
She further stated that reducing the number of opioid overdose deaths in Pennsylvania will require an inclusive, multi-pronged approach aimed at curbing both the supply and demand for drugs.
“If the demand is sky high, then it’s almost impossible to cut the supply. So what we have to do in public health is work on the demand issue, and then can do a better job at cutting off the supply.”
Levine also emphasized that addiction is “a chronic, relapsing brain disease”, and not a a moral failing. She added that “it’s critical for us to instill hope in patients, for their families, for our communities, and for our commonwealth.”
Pennsylvania Statistics 2015
- White males, aged 30-39 accounted for 15% of overdose deaths; however, this group comprises less than 5% of the state’s total population.
- White males in general accounted for two-thirds of opioid-related overdose deaths.
- Whites accounted for 3 out of 4 opioid-related overdose deaths in 2015.
- African-Americans accounted for around 14% of deaths related to illicit drugs, and make up just less than 12% of the population.
- Asians, Hispanics, and others accounted for less than 1% for all age groups.
Pennsylvania counties with the highest number of overdose deaths include per 100,000 residents:
- Philadelphia (46)
- Armstrong (43)
- Cambria (43)
Of the 3,500 overdose fatalities in the state, nearly half showed the presence of an opioid, including but not limited to the following:
- Acetyl fentanyl, which was found in 4% of all overdose deaths, but completely absent in 2014
- Fentanyl, showing the largest increase in prevalence at 93% over 2014.
- Hydrocodone (Vicodin)
- Oxycodone (OxyContin)
According to the Center for Disease Control and Prevention, there were more than 52,000 fatal overdoses in 2015. Of those, 33,000 involved an opioid or opiate. Overdose deaths are now more common than deaths resulting from traffic accidents.
You can read more about mental health services and substance abuse treatment covered by the Affordable Care Act here.
~ G. Nathalee Serrels, M.A., Psychology